Episode 80: How to Handle Neurosurgical Emergencies in the Peds ER? Interview with a Pediatric Neurosurgeon Dr. Todd Hankinson

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As a PEM Physician, I get to take care of children with neurosurgical problems fairly often. Sometimes it is children with known issues such as hydrocephalus with a shunt and sometimes it is a patient with traumatic injury.  Pediatric neurosergeons are often life savers in those situations. Here is a conversation I had with Dr. Todd Hankinson, a Pediatric Neurosurgeon at Children’s Hospital of Colorado.

 

 


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Episode 78: Interview with Jason Zamkoff, a Pediatric Hospitalist In Denver CO.

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Probably the Pediatric Sub-specialists I interact with the most are the pediatric hospitalists. Not only they accept my admissions but often give advice about the work up that the patient needs and serve as an extension of the Pediatric Emergency Department.

That is why I invited Jason Zamkoff, a Pediatric Hospitalist from Denver CO to talk about the relationship between PEM Clinicians and the Peds Hospitalists. 

 

Please consider contributing to PEM Rules at

https://ko-fi.com/pemrules

And check out www.pemrules.com 

 

Copyright PEM Rules LLC

 

 

 

DISCLAIMER

By listening to this podcast, you agree not to use these resources as medical advice to treat any medical conditions in either yourself or others, including, but not limited to, patients that you are treating. Consult your own physician for any medical issues that you may be having. This entire disclaimer also applies to any guests or contributors to the podcast or website. Under no circumstances shall PEM Rules, the PEM Rules podcast or any guests or affiliated entities be responsible for damages arising from their use.

This podcast should not be used in any legal capacity whatsoever, including, but not limited to, establishing “standard of care” in a legal sense or as a basis for expert witness testimony. No guarantee is given regarding the accuracy of any statements or opinions made on the website or in the podcast.

 

 


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Episode 76: Dealing with Acute (and Chronic) Pain in the Pediatric Emergency Department

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As a PEM physician, treating pain is a big part of my life and sometimes it is easier said than done. This why I invited Dr. Alan Bielskay, a Pediatric Anesthesiologist (and pain expert) from Denver CO to talk about pain treatment in children.

 

 

Please consider contributing to PEM Rules at

https://ko-fi.com/pemrules

And check out www.pemrules.com 

 

Copyright PEM Rules LLC

DISCLAIMER

By listening to this podcast, you agree not to use these resources as medical advice to treat any medical conditions in either yourself or others, including, but not limited to, patients that you are treating. Consult your own physician for any medical issues that you may be having. This entire disclaimer also applies to any guests or contributors to the podcast or website. Under no circumstances shall PEM Rules, the PEM Rules podcast or any guests or affiliated entities be responsible for damages arising from their use.

This podcast should not be used in any legal capacity whatsoever, including, but not limited to, establishing “standard of care” in a legal sense or as a basis for expert witness testimony. No guarantee is given regarding the accuracy of any statements or opinions made on the website or in the podcast.


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Episode 75: Clinical Care Tips – Making Decisions, Testing for Bacteremia and “Going with Your Gut”

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Sometimes decisions are hard to make, nonetheless, in the ED world it is important to make a decision and sometimes sooner rather than later. Why getting a blood culture (without giving antibiotics) makes no sense to me and more about going with your gut feeling.

 

Please consider contributing to PEM Rules at

https://ko-fi.com/pemrules

And check out www.pemrules.com 

 

Copyright PEM Rules LLC

 

DISCLAIMER

By listening to this podcast, you agree not to use these resources as medical advice to treat any medical conditions in either yourself or others, including, but not limited to, patients that you are treating. Consult your own physician for any medical issues that you may be having. This entire disclaimer also applies to any guests or contributors to the podcast or website. Under no circumstances shall PEM Rules, the PEM Rules podcast or any guests or affiliated entities be responsible for damages arising from their use.

This podcast should not be used in any legal capacity whatsoever, including, but not limited to, establishing “standard of care” in a legal sense or as a basis for expert witness testimony. No guarantee is given regarding the accuracy of any statements or opinions made on the website or in the podcast.

 


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Episode 74: Child Abuse in the Pediatric Emergency Department, How Can We Make Things Better?

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As a PEM Physician, child abuse, sexual abuse and child neglect cases are those cases I never want to miss or overlook. That is often easier said than done. This is a discussion I had with Dr. Stephen Boos, a child abuse doctor in Western MA.


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Thank you all for listening to PEM Rules!  As requested, please see list of references below used for Dr. Boos’s Child Abuse guidelines as well as the guidelines used at the Childrens’ Hospital of Pittsburgh,

References:

Hymel KP, Laskey AL, Crowell KR et al. Racial and ethnic disparities and bias in the evaluation and reporting of abusive head trauma. J Pediatr. 2018; DOI:10.1080/10538712.2018.1443303

Rinney LC, Frey TM, Fain ET, et al. Standardizing the evaluation of nonaccidental trauma in a large pediatric emergency department. Pediatr. 2018; DOI:10.1542/peds.2017‐1994

Wood JN, Fakeye O, Mondestin V, et al. Development of hospital‐based guidelines for skeletal survey in young children with bruises. Pdiatr. 2015; DOI:10.1542/peds.2014‐2169

Wood JN, Fakeye O, Feudtner C, et al. Development of guidelines for skeletal survey in young children with fractures. Pediatr. 2014; DOI:10.1542/peds.2013‐3242

Wootton‐Gorges SL, Soares BP, Alazraki AL, et al. ACR appropriateness criteria suspected physical abuse‐ child. J Am Coll Radiol. 2017; 14: S338‐S349

Pierce MC, et al. Validation of a Clinical Decision Rule to Predict Abuse in Young Children Based on Bruising Characteristics. JAMA Netw Open. 2021 Apr 1;4(4):e215832. doi: 10.1001/jamanetworkopen.2021.5832.

Escobar, M. A,. Flynn-O’Brien, K. T., et al… (2017). The association of nonaccidental trauma with historical factors, examination findings, and diagnostic testing during the initial trauma evaluation. Journal of Acute Care Surgery, 82(6), pp. 1147-1157

ACS Trauma Quality Programs Best Practices Guidelines for Trauma center Recognition of Child Abuse, Elder Abuse, and Intimate Partner Violence Abuse-Violence.pdf (pediatrictraumasociety.org)

Berger RP, Fromkin ,J Herman B, Pierce MC, Saladino RA, Flom L, Tyler-Kabara EC, McGinn T, Richichi R, Kochanek PM. Validation of the Pittsburgh Infant Brain Injury Score for Abusive Head Trauma. Pediatrics. 2016 Jul;138(1):e20153756. doi: 10.1542/peds.2015-3756. Epub 2016 Jun 23. PMID: 27338699; PMCID: PMC4925074.